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HomeMy WebLinkAboutEHPR-05-2016-23919.TIF Y-,A THIS IS NOT A PERMIT Case # EHPR-05-2016-23919 'fir - CATAWBA COUNTY HEALTH DEPARTMENT 0 .47 •O . 0 ` llO° PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1 42 sM Environmental Health Plan Review - Septic Malfunction •12 . o .0 S AUTH CONST- SEPTIC MALFUNCTION •-, o To Owner EDWARD & MELISSA PACE, 1864 GRANDVIEW DR, NEWTON NC 28658 H:9804224408 C:7046158378 HOME:9804224408 NAME TO APPEAR ON PERMIT Edward & Melissa Pace SITE ADDRESS: 1864 GRANDVIEW DR, NEWTON NC 28658 PIN # 363914443420 NAME of SUBDIVISION: Lot# A Section/Block PROPERTY SIZE: Square Feet 122,403.60 Acres 2.81 DIRECTIONS: W NC Hwy.10, Right Jarret Farm Rd, Right Grandview Dr, 2nd house on the Lot. PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Private Well DESCRIBE WORK: Tank Only Replacement* Crack found in tank during septic inspection. SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF House, Barn EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: House 102x66, Barn 34x44 NUMBER OF EXISTING BEDROOMS: 4 #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions.An Authorization to Construct issued by this department is valid for(5)five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application,site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so complete site evaluation can be performed. Date: Fj—'.� Vs Signature of Applicant or Agent' 'e--tisC An Environmental Health Specialist will contact you within 5 1, orking days of application date. If you need further information or assistance please call 828-466-7291 AREA1 09-ehapplication 05/23/2016 08:51 Page I of7 /e' • CATAWBA COUNTY Case n EHPR-OS-2016-23919 A'Lin j Public Health Department Subdivision 4 •'tH Environmental Health Division PINK ^c 363914443420 �`^'4t-2 u PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 84 NAME ON PERMIT: (EDWARD&MELISSA PACE), 1864 GRANDVIEW DR,NEWTON NC 28658 ( Edward & Melissa Pace) Site Address: 1864 GRANDVIEW DR,NEWTON NC 28658 Property Size: Square Feet 122,403.60 Acres 2.81 Directions: W NC Hwy 10, Right Jarret Farm Rd, Right Grandview Dr, 2nd house on the Lot. FE NAMIE ii i'.N11 till r �1i '� i a �1° T'1 �'�aDATE i(n: I11'IFEE!.AMOUN I ' t ,,. 1 P�J,lip ki::��u Authorization to Construct(Repair) Fee 05/23/2016 $150.00 1 �a i, ° 1. 1 lT9181).: EES ._ t'r ifi lliil 1IlHlllli ills u t i 1 :y 1 ` -°1$150 6: : y �h Ii�ll! �IIIU'�i �jHilwf �I{III h.. AL it ,;. s 1a lliiiisa go,,`- . ,4n,gafe eee.a eteanan.a.;uralJtalala p m , arg)PL t 1fillP "'E FEES ARE NON—REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9-ehapplicetion 05/23)2016 08:51 Page 2 of 7 CAA\\ THIS IS NOT A PERMIT Lou11e ,1T LA� CATAWBA COUNTY HEALTH DEPARTMENT = Application for Environmental Services Page 1 Improvement Permit Authorization to Construct ❑ Septic Repair Septic Malfunction IX Septic Expansion ❑ New Well Permit E Replacement Well ❑ Well Abandonment I I . Well Repair _ Existing System Inspection (Pre-Approval Required) ❑ Application is for New Construction El Existing Facilit3 Property Address \p 1d4 *-af)dtkr l>J iNg,_,_ Subdivision tJeWitn ttC 9$W05ck Lot# Acres Section/Block/Phase Driving Directions to Property Dyy RDote \ NAME TO APPEAR ON PERMIT?/Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address Phone Cell Phone Owner Contact Information Name %8v-xicd, and Pl tli6sa Fes- ace- Address l%lpt.k Caxandvie?w -be INewta, L, MC T$(Q5g Phone ocsb Lkaa c{,-lDs Cell Phone "i.04 Lp1.t 8 1W Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor . Description of Existing Structu es on Site (.i z/\\\\\\ // , / # of Bedrooms *j Structure D`imens onset 3tl� X W� �#of Occupants Li Basement U Yes No Basement Fixtures Yes No )Y ^m 3-4)( (4 —^ The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property ip question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes CJ/No Does the site contain any jurisdictional wetlands? O Yes K3�No Does the site contain any existing wastewater systems? o Yes tr �To Is any wastewater going to be generated on the site other than domestic sewage? El Yes —/No Is the site subject to approval by any other public agency? ®Yes Ea/No Are there a easements or right of ways on this property? Describe Existing water supply in use �7 Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line Is a public water supply available? ** n Yes n No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): J (systems can be ranked in order of your preference) ❑ Accepted 11 Alternative ❑ Conventional ❑ Innovative ❑ Other VAny C' /, TA TP.A THIS IS NOT A PERMIT cots r � 1Lh CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type Primary Residence ❑ New Residence _ Addition to Residence # of New Bedrooms *1- Project Description_ Structure Dimensions #of Occupants Basement n Yes ❑ No Basement Fixtures ® Yes ® No ❑ Accessory Structure(s) Describe # of New Bedrooms *j if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes n No Plumbing ❑ Yes n No Describe Plumbing Needed Multi-Family Residence#Units #Bedrooms per Unit*t Total# Bedrooms tt Structure Dimensions I Food Service Specify Type # Seats Floor Space-Entire Food Service Facility (Sq Ft) # Employees per Shift #of Shifts Dining Area (Sq. Ft.) n Business Specific Type of Business Retail Floor Space # of Employees per Shift #of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes In No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well Semi-Public Well n Community Well Abandonment Type n Drilled n Bored ❑ Dug n Unknown Well Repair Requested ❑ Yes P No Describe Calculated Design Flow, Commercial t Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on-site staff. *Any room that will be intended for sleeping at die time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. t If structure is plumbed but no bedrooms, calculated design flow is required. **If No,a well permit must be issued with the Authorization to Construct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid for 5 years or may be non-expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for(5) five years from the date issued and is not transferable;Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent`i cx WO- °Q Date 5)of 3\V P Printed Name of Owner or Agent MCA\Sta. A . cace. Catawba County Environmental Health ��1551 774 326.68 386.86 r-- p rn N- N N 0 r<� 62.70 • "t' co tri CD 910 (210 101.38 Parcel: 363914443420, 1864 GRANDVIEW DR 1in=60ft NEWTON, 28658 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba, its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct, indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 05/23/2016 Parcel Report Page 1 of 1 Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 363914443420 Owner: HAIGLER BRIAN Parcel Address: 1864 GRANDVIEW DR Owner2: null City: NEWTON, 28658 Address: 4704 KIDDLE LN LRK(REID): 36897 Address2: null Deed Book/Page: 3290/0609 City: MONROE Subdivision: State/Zip: NC 28110-7663 Lots/Block: N School Information: Last Sale: School District: COUNTY Plat Book/Page: 28/28 Elementary School: STARTOWN Legal: LOT A PLAT 28-28 Calculated Acreage: 2.810 Middle School: MAIDEN High School: MAIDEN Tax Map: 070N 04005E School Map Township: NEWTON State Road #: 2072 Tax/Value Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: NEWTON County Fire District: NEWTON RURAL Zoningl: R-20A Building(s) Value: $146,800 Zoning2: Land Value: $30,000 Zoning3: Assessed Total Value: $176,800 Zoning Overlay: Year Built/Remodeled: 1972/null Small Area: null Current Tax Bill Split Zoning Districts: null/null Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permits for this parcel. Firm Panel #: 3710363900J Building Details 2010 Census Block: 2053 WaterShed: null 2010 Census Tract: 011701 Voter Precinct: P34 Agricultural District: Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,toss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. ©2016, Catawba County Government, North Carolina. All rights reserved. http://gis.catawbacountync.gov/nomap/parcel_report.php?key=363914443420&typ=P 5/23/2016 r , � � c C v �. ` > 0 t av a .. , oo a O u a p o 3 w 1p a Ln r o ti• z n a W � ` c . 3 kJ) n c -c) a S L>: N c.2 cfi c o tit J cf) . : O r 0 J O x v O H M _c q w� (... 1.111%! ` y n ' 'E a � ~J Q " 1� \a cn -B WI" ` ' 0 '� - a'• V ° ~ �i' „ U CO 0. H • F' Q �} cn • : a U o a p c ' Q W p 'o cr, G o , in ~ a m ie, g O a o Ln 1, ~ r . T 45 -0. c O o J w b f— ° a. Q Q Q c I. 11 H U Y r� 0 y N. . O W Z '. H 4 J o 1 W 3 v a c yl z �a 4.1 r- t a . 4 a ,-, Z 0 V d�l.t V. 1 i.5 n } ' t 1r .n ■ rKi. w O 1 i ,t4W w 4 l■ a to c - T o Fif V � >- y \ N v CK.`y 1. �ell I O O Z > 'Iv, O C v C... ..v Z o ..- N A 0 0 , O a a IN EN., N 5 N O O O 0 �„yh1 c o a a l •�0 W 3 N N Q �' ` C y ISt a. 0 H E -1 . Y u Via. . . ON—SITE WASTEWATER < .�' ,y511Rt3.,. I }'il 4i' i(�phNtn ?NUIa g4�115 El' l: 1 ' ' ) ;' '�1 ) , 1� INSPECTION REPORT (Page 1 of 3) 'Atli ,-•i VII DATE OF INSPECTION 24 Mar 2016 Environment& Services JACK MOORE Inspector Certification#12331 Street Address 1864 Grandview Dr DAVID LYNCH Inspector Certification#43121 Clt� Newton State NC ZIP 28658 J.C. Moore Phone (704) 873-2171 1227 Troutman Drive Fax (704) 873-9928 CLIENT NAME Kim Brueckner Statesville, NC 28625 Mobile(704) 902-1122 Showcase Realty, LLC Kim Brueckner Realtor - Showcase Realty, LLC Dear Kim: At your request, on March 24, 2016, I inspected the septic system at 1864 Grandview Dr, Newton, NC. The following is an inspection form that is required by the NC Onsite Wastewater Board. Enclosed is a copy of the permit for this system from the Catawba County Environmental Health Department and a site drawing I made that shows the location of the septic system. Also included is a copy of the MLS, some pictures of the site, the signed pre-inspection contract, and the invoice. I opened the septic tank and found that it is in poor structural condition. There were cracks leading outward from the outlet lid opening. If the cracks worsen, the tank could be considered a safety hazard and it would be recommended to be replaced. The concrete sanitary tee is located on the outlet end of the septic tank. It was very deteriorated and should be replaced with a PVC sanitary tee. The sludge and scum layers were excessive; therefore, the tank needs to be pumped by a licensed septic pumper. The drain field consists of a conventional gravity 'bed' measuring roughly 12' x 63'. It is designed to be equivalent to a total linear length of 255'. The drain field was functioning properly on the date of my inspection. Sincerely, David Lynch Subsurface System Operator (Cert. #996383) NC Onsite Wastewater Inspector (Cert. #43121) „ 0"ii ON-SITE WASTEWATER `m3i ra��f lm I( , `' � Illl � f.l�l) Iiifl.ill B elb .fl 11 ,'It �)ft ,rni 11111 Be lb REPORT (Page 2 of 3) Environment& (p, Services DATE OF INSPECTION 24 Mar 2016 JACK MOORE Inspector Certification#12331 Street Address 1864 Grandview Dr DAVID LYNCH Inspector Certification#43121 City Newton State NC ZIP 28658 J.C. Moore Phone (704) 873-2171 1227 Troutman Drive Fax (704) 873-9928 CLIENT NAME Kim Brueckner Statesville, NC 28625 Mobile(704) 902-1122 Showcase Realty. LLC Q Pre-Inspection Contract, signed by Client(or client's representative)is attached to Inspection Q Inspection shall include any part of the system located 4 Advertised number of bedrooms as stated in more than 5 feet from the primary structure that is attached sworn statement by owner or owner's representative part of the operations permit Q Copy of Operations Permit from Number of bedrooms/Gallons per day for County Environmental Health attached designed system size or as stated in available local health Operations Permit not available department information ❑ System requires a certified subsurface water pollution control system operator pursuant to G.S.90A-44 Type of water supply: Well Current Operator's Name Date septic tank was last pumped: Most recent performance, operation and maintenance reports are SEPTIC TANK 12 ft from house or structure 75 ft from well if applicable ft from water line if applicable or known ft from property line if said property lines are known or marked -18” distance from finished grade to top of tank or access riser No Access riser(s)present? comments Yes Tank lids intact? Comments No Tank is in good structural condition? comments Tank has two major cracks leading outward from the outlet lid opening Yes Tank has baffle wall? comments Yes Inflow to tank is unobstructed? comments No Water level in tank is relative to tank outlet? Water level is down to the middle seam of the tank No Outlet sanitary T is present in good condition? Concrete sanitary tee is present, but is almost completely deteriorated No Sanitary T has a filter installed? comment, Yes Effluent leaves the outlet? comment, No Are roots present in tank? comments No Is there evidence of tank leakage? comments Yes Connection is present from house to tank Yes Connection is present from tank to next component 40% Percentage of solids noted in tank comments Very dense sludge laver PUMP TANK Does system have pump tank? fl YES(Complete blanks below) 0 NO ft from house or structure ft from well if applicable ft from water line if applicable or known ft from property line if said property lines are known or marked ft from Septic Tank distance from finished grade to top of tank or access riser Electrical connections are in place and properly grounded? Comments Audible and visible alarms(as applicable)work? comments Pump turns on and effluent is delivered to next component? comments Describe condition of tank lids/access riser: comments Describe location of control panel: comments ON-SITE WASTEWATER P, S 1191 tJ Il0ml E n1A, ,t 1'� i, \) 1 ~ INSPECTION REPORT (Page 3 of 3) DATE OF INSPECTION 24 Mar 2016 Environmental lac Services JACK MOORE Inspector Certification#12331 Street Address 1864 Grandview Dr DAVID LYNCH Inspector Certification#43121 City Newton State NC 21p 28658 J.C. Moore Phone (704) 873-2171 1227 Troutman Drive Fax (704) 873-9928 CLIENT NAME Kim Brueckner Statesville, NC 28625 Mobile(704) 902-1122 Showcase Realty. LLC DRAIN FIELD Type of System: 0 Conventional n Innovative ❑Pretreatment; Type of Pretreatment: Brief Description of System Type: Type II conventional gravity system with gravel 'bed' drain field Number of lines: Total linear footage of drain field: 255 10 ft from house or structure 90 ft from well if applicable 3 ft from Septic/Pump Tank ft from property line if said property lines are known or marked Yes Effluent is reaching the drain field? comments No Is there evidence of traffic over the drain field? Comments No Is there vegetation,grading,or drainage that may affect the condition of the system or system components? Comments No Were there conditions present that prevented or hindered the inspection? No Any adverse conditions present that require repair, subsequent observation, or further evaluation from the local health department? Other pertinent facts noted during inspection / general comments: Solids in the septic tank exceed 1/3 of the liquid depth. According to NC Sewage Rules, the tank should be pumped. If a decision is made to replace the septic tank, the Catawba County Environmental Health Dept will need to be contacted to obtain a repair permit. No representation, warranties,or opinions are hereby given, written, or expressed otherwise,as to the future performance of the onsite wastewater system described herein. This onsite wastewater system inspection is o presentation of system facts in place on the date of inspection. Date 24 Mar 2016 Inspector Signature �� p'A CATAWBA COUNTY O� IOOA SOUTHWEST BLVD RECEIPT 5 1 ``; if NEWTON,NORTH CAROLINA 28658 \U M` ��1sk PHONE: 828.465.8399 ire" Monday, May 23, 2016 184' sm www.catawbacountync.gov PAYOR: Pace, Edward&Melissa PAYMENTS TRANSACTION NUMBER: TRC-677509-23-05-2016 PAYMENT DATE : 05/23/2016 PAYMENT TYPE: Credit Card INVOICE NUMBER FEE NAME FEE AMOUNT 05-16-328593 Authorization to Construct (Repair) $150.00 Fee TOTAL PAYMENTS : 5150.00 EHPR-05-2016-23919 CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 1864 GRANDVIEW DR,NEWTON NC 28658 Owner EDWARD& MELISSA PACE, 1864 GRANDVIEW DR,NEWTON NC 28658 H:9804224408C:7046158378 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 05/23/2016 08:51 Page 1 of I